Contraception Clinical Trial
Official title:
Transatlantic Active Surveillance on Cardiovascular Safety of NuvaRing (TASC)
The objective of this study is to characterize and compare the risks of short- and long-term use of NuvaRing® with marketed combined oral contraceptives.
This is a large, multinational, controlled, prospective, active surveillance study of women
who are prescribed NuvaRing® or an oral contraceptive (OC). The study follows two cohorts.
The cohorts consist of new users (starters and switchers) of two different groups of
hormonal contraceptives:
- NuvaRing®
- marketed combined OCs (combined oral contraceptives)
NuvaRing® is a transparent and flexible contraceptive vaginal ring containing etonogestrel
and ethinylestradiol (EE). The ring releases 15 mcg EE and 120 mcg etonogestrel daily. After
insertion it remains in the upper part of the vagina for 21 days, followed by 7 ring-free
days before a new ring is inserted.
The primary objective of this study is to characterize and compare the risks of short- and
long-term use of NuvaRing® with marketed combined OCs. The main clinical outcomes of
interest for the short and long-term follow-up are:
- Deep Venous Thrombosis (DVT)
- Pulmonary Embolism (PE)
- Acute Myocardial Infarction (AMI)
- Cerebrovascular Accidents (CVA)
Secondary objectives are:
- to analyze the drug utilization pattern of NuvaRing® and marketed OCs in a study
population that is representative for typical use of the individual contraceptive
methods under routine medical conditions
- to characterize the baseline risk of users of the individual formulations
- to assess the compliance of NuvaRing® users and users of marketed OCs
- to analyze the reasons for discontinuing the treatment with NuvaRing® and/or marketed
OCs.
The study will use a non-interference approach to provide standardized, comprehensive,
reliable information on these treatments in a routine clinical practice setting.
Study participants will be recruited via an international network of more than 1000
gynecologists. After study entry cohort members will be followed for a period of 30 to 48
months for rare serious safety outcomes. Regular, active contacts with the cohort members by
the study team of the Berlin Center for Epidemiology and Health Research (ZEG), Germany will
provide the necessary information on health-related events or changes in health status (=
active surveillance).
Approximately 15,000 subjects per cohort will be recruited by participating physicians in
order to provide approx. 86,000 women-years (WY) of observation. Subjects will be considered
for enrollment in this study after the participating physician has determined that NuvaRing®
or OC use is appropriate. There will be no specific inclusion/exclusion criteria. All women
who are eligible are to be asked by their physician if they are willing to participate. As
this a non-interventional study, the possibility to participate in the study should not be
discussed with the patient before both - physician and patient - agree upon the
prescription.
The study will be conducted in several European countries and the United States.
The study will be divided into 2 phases: a baseline survey which includes an initial
consultation at baseline with a participating physician, and a follow-up phase which
includes two follow-up contacts within the first year and then annual follow-up contacts for
up to 4 years post-baseline.
The study will maintain scientific independence and will be governed by an independent
Safety Monitoring and Advisory Council (SMAC). The Berlin Center for Epidemiology and Health
Research (ZEG) and its research team will be accountable to the council in all scientific
matters. The members of the council will be international experts in relevant scientific
fields (e. g., epidemiology, drug safety, gynecology, cardiology, statistics,
endocrinology).
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